Mayor William P. Kenoi made the emergency proclamation Monday. Officials are using mosquito control measures along with public education and outreach to break the cycle of infection and transmission.

The emergency period will be in place for 60 days or until further notice from officials.

Dengue fever is transmitted by infected mosquitoes. The disease causes flu-like symptoms such as high fever, nausea and joint and muscle pain. In severe cases it can cause bleeding from the nose or gums, persistent vomiting and can be fatal, according to Health Canada.

Symptoms typically appear three to 14 days after a bite, and protecting yourself from mosquito bites is the best way to avoid infection. There is no vaccine or medication to prevent infection.

Dengue fever is not spread from person to person.

Of the confirmed cases on the island, 227 are Hawaii Island residents and 24 are visitors.

The Hawaii Department of Health (HDOH) says it is “investigating a cluster of locally-acquired cases of dengue fever on Hawaii Island.”

The health agency states that dengue is not endemic to Hawaii, but is occasionally brought in by infected travellers.

“The Big Island and the rest of Hawaii remain safe destinations for visitors and residents,” the HDOH states.